Hygienemaßnahmen bei Infektionen oder Besiedlung mit multiresistenten gramnegativen Stäbchen

doi:10.1007/s00103-012-1549-5

Cited by 281 publications

(54 citation statements)

References 124 publications

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“…The huge standard deviation of CP duration indicates that not all of the ESBL colonized patients were on CP. In Germany, only a fraction of patients with gram negative multidrug-resistant germs needs to be isolated, in particular on ICU or wards with immunosuppressed patients [8].…”

Section: Discussionmentioning

confidence: 99%

“…In a few patients, ESBL colonization was detected later during their rehabilitation. All patients colonized with 4MRGN have been isolated while 3MRGN carriers were only on CP when they were admitted to an ICU or intermediate care unit (IMC) of the BDH-Clinic Hessisch Oldendorf [8].…”

Section: Methodsmentioning

confidence: 99%

“…4 out of 4 groups of antibitotics: ureidopenicillins, third/fourth generation cephalosporins, carbapenems, quinolones) [8]. Contact precautions (CPs) are generally recommended for hospital inpatients colonized with 4MRGN, while CPs for patients with 3MRGN are only suggested on intensive care units (ICU) and wards with immunosuppressed patients [8].…”

Section: Introductionmentioning

confidence: 99%

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Outcome of Early Neurological Rehabilitation Patients Colonized with Extended-Spectrum Beta-Lactamase (ESBL) Producing Bacteria

Rollnik¹

2015

OJTR

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Colonization with multidrug-resistant germs, in particular methicillin-resistant Staphylococcus aureus (MRSA) and extended-spectrum beta-lactamase producing bacteria (ESBL), is an emerging threat in early neurological rehabilitation. This study examined whether colonization with ESBL bacteria had deteriorating effects on neurological rehabilitation patients because of contact precautions (CP) 2 (20.2) vs. 140.2 (18.7) min/day, n.s.), but the overall sum was significantly larger in the ESBL group due to longer LOS (p < 0.001). Mortality of both groups was comparable (3.8% vs. 4.1%). 54.3% of ESBL negative patients were discharged to home, but only 34.5% of ESBL colonized. 48% of ESBL positive patients were discharged to a nursing home, but only 25.1% of the ESBL free patients. Functional recovery of ESBL carriers undergoing neurological early rehabilitation is worse than that of patients without multidrug-resistant germs. Poorer outcome is not resulting from less therapy due to CP, but from functional status and higher morbidity on admission..

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Outcome of Early Neurological Rehabilitation Patients Colonized with Extended-Spectrum Beta-Lactamase (ESBL) Producing Bacteria

Rollnik¹

2015

OJTR

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“…Also, procedures and processes of bacterial isolation are being described together with up-to-date references to multiresistant Pseudomonas sp. (MRGN) [6] [7].…”

Section: Guidelines In Cystic Fibrosismentioning

confidence: 99%

Maintaining Nursing Care Quality—Clinical Care Guidelines for Cystic Fibrosis: Outpatient and Inpatient

Koeller¹,

Meyer²

2016

CRCM

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The Care Committee of the Mukoviszidose e.V., headed by Cornelia Meyer, has drawn up a completely revised version of the German Guidelines to Care in Cystic Fibrosis. It addresses all nursing staff concerning children, adolescents or adults with cystic fibrosis (CF) either in an inpatient and outpatient setting or in rehab clinics. The guidelines evolve along with the increased life expectancy of cystic fibrosis patients and improved quality of life which is described by CF patients and can be observed by the therapeutic CF team. For example, the treatment of secondary diseases like CFDR (CF related diabetes) which comes along with an increased life expectancy has been added over the years. It is essential that within such a complex disease pattern, professional experience of care staff who worked in specialized CF care centers (50+ patients per year) for many years has to be transferred to other nursing stuff or beginners. This is especially important in the context of the heterogeneous characteristics of this disease. Often it can be seen that the quality of the care for CF patients depends on the know-how and professional experience of the interdisciplinary CF therapists team. Moreover, it depends on the knowledge which the patient has gathered by himself by experience or learning. And, of course, it depends also on the knowledge of the relatives especially parents or partner respectively.

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“…It has, on the other hand, slightly decreased in high risk settings such as intensive care and surgical wards, where the proportion of MRSA among nosocomial Staphylococcus aureus infections decreased from 33 % to 27 % in the period from 2007 to 2012 [8]. In contrast, there has been a rise in the number of multiresistant Gram-negative bacteria (MRGN), such as third-generation cephalosporin (3GC)-resistant Escherichia coli and 3GC-resistant Klebsiella pneumoniae [9–12]. The prevalence of vancomycin resistance is also increasing in Germany, but this is mainly restricted to strains of E. faecium .…”

Section: Introductionmentioning

confidence: 99%

Improving hospital hygiene to reduce the impact of multidrug-resistant organisms in health care–a prospective controlled multicenter study

et al. 2015

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BackgroundNosocomial infections are the most common complication during inpatient hospital care. An increasing proportion of these infections are caused by multidrug-resistant organisms (MDROs). This report describes an intervention study which was designed to address the practical problems encountered in trying to avoid and treat infections caused by MDROs. The aim of the HARMONIC (Harmonized Approach to avert Multidrug-resistant Organisms and Nosocomial Infections) study is to provide comprehensive support to hospitals in a defined study area in north-east Germany, to meet statutory requirements. To this end, a multimodal system of hygiene management was implemented in the participating hospitals.Methods/designHARMONIC is a controlled intervention study conducted in eight acute care hospitals in the ‘Health Region Baltic Sea Coast’ in Germany. The intervention measures include the provision of written recommendations on methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococci (VRE) and multi-resistant Gram-negative bacteria (MRGN), supplemented by regional recommendations for antibiotic prescriptions. In addition, there is theoretical and practical training of health care workers (HCWs) in the prevention and handling of MDROs, as well as targeted and critically gauged applications of antibiotics.The main outcomes of the implementation and analysis of the HARMONIC study are: (i) screening rates for MRSA, VRE and MRGN in high-risk patients, (ii) the frequency of MRSA decolonization, (iii) the level of knowledge of HCWs concerning MDROs, and (iv) specific types and amounts of antibiotics used.The data are predominantly obtained by paper-based questionnaires and documentation sheets. A computer-assisted workflow-based documentation system was developed in order to provide support to the participating facilities. The investigation includes three nested studies on risk profiles of MDROs, health-related quality of life, and cost analysis. A six-month follow-up study investigates the quality of life after discharge, the long-term costs of the treatment of infections caused by MDROs, and the sustainability of MRSA eradication.DiscussionThe aim of this study is to implement and evaluate an area-wide harmonized hygiene program to control the nosocomial spreading of MDROs. Comparability between the intervention and control group is ensured by matching the hospitals according to size (number of discharges per year / number of beds) and level of care (standard or maximum). The results of the study may provide important indications for the implementation of regional MDRO management programs.

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Hygienemaßnahmen bei Infektionen oder Besiedlung mit multiresistenten gramnegativen Stäbchen

Cited by 281 publications

References 124 publications

Outcome of Early Neurological Rehabilitation Patients Colonized with Extended-Spectrum Beta-Lactamase (ESBL) Producing Bacteria

Outcome of Early Neurological Rehabilitation Patients Colonized with Extended-Spectrum Beta-Lactamase (ESBL) Producing Bacteria

Maintaining Nursing Care Quality—Clinical Care Guidelines for Cystic Fibrosis: Outpatient and Inpatient

Improving hospital hygiene to reduce the impact of multidrug-resistant organisms in health care–a prospective controlled multicenter study

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